1546 Baylor Ct 06/23/2009 07:25 FAX z001
For Office Use
City of EaRal Permit
3830 Pilot Knob Road Permit Fee: i
Eagan MN 55122 I
Phone: (651) 675-5675 Date Received:
Fax: (651) 675-5694 staff:
2009 RESIDENTIAL PLUMBING PERMIT- APPLICATION
Date: r tiC -0 q Site Address '46
Tenant: Suits
RESIDENT l OWNER Name: Ek A Qt 'N Phone:
Address /City 1 Zip:
_
141 LIZ:
CONTRACTOR Name: l o.-- . t C~~ cttw~{b f~ <a License*-
Address: 1 a- L) j ,
City: _ ' A _ ) 4 -c * LLir State: _ Zip: Loq
Phone: Contact PersoA+ A NgTYPE OF WORK _ New Leplacement - Repair _Rebuild _ Modify Space _W rk in R.O.W.
Description of work:
PERMIT TYPE RES/~7EN7"!AL
-2/°~5(vater Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ / _ PVB) L Main,,,,` Lower Level)
Septic System Water Turnaround
New
Abandonment
R IAL FEES:
7
50.50 M im m Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcha ge)
'Water Turnaround (add $165.00 if a 518" meter is required)
$100.50 Septic System N ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Fagan; that I understand this Is not a permit, but only an application for a permit, and work is not to start without a permit; that he work wiN be In
accordance with the approved plan in the case of work which squires a review and approval of ans.
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Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground -,-,Rough-In _Air Test Gas Test Final
w t~ L L P" Q y e, RbG t~
ti
Use BLUE or BLACK Ink
I For Office Use
of l,/ii po + Permit
Permit Fee: 5a .
3830 Pilot Knob Road
Eagan MN 55122 Hate Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 staff:
1
----------------J
2013 RESIDENTIAL BUILDING PERMIT APPLICATION #
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Date: Ib Site Address: ~Jr /51138 Q~wso+r,
Resident/ Name:1 2/n__ Jl~~ 7_t1 j0 h 60M,0_ SPhone:
!Owner Address / City / Zip:
Applicant is: Owner Y_ Contractor
Type of Work Description of work: JRerDOr~-
~ ~ -
Construction Cost: ~O Multi-Family Building: (Yes _No
Company:- Cr) n 1/47/GW----- Contact: ~ 7een
Ck71iG#Or Address:__a0 ?J t " 1 t~YJ~'ld~ _ City:
State: A2 A! _ Zip: 5-Y(/64 Phone: (012- ?2-1-
License - L 0 6 2- Lead Certificate _AzAf = 2
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
-Yes --No if yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: - Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you subn* are considered to be public Information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that tha are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454.0002 for protection against underground utility damage. Cat 48 hours
before you intend to dig to receive locates of underground utilities. www.gopheE tateonecall.gM
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and corks of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
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Applicant's Printed Name Applica s Signature
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